EmailMe Form - Breathless Beach Bash Registration

Registration Instructions
Please list your name as it appears on your passport or government issued identification that you will be traveling with.
Passenger 1
Name *
First Last
Date of Birth *
MM / DD / YYYY
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Email *
Phone *
### - ### - ####
Passenger 2
If passenger #2 has the same address as passenger #1, you do not have to list the address again.
Name
First Last
Date of Birth
MM / DD / YYYY
Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Email
Phone
### - ### - ####
Credit Card Authorization
If you have any questions or concerns that need to be addressed before submitting this form, please feel free to contact Felicia Hepburn at (224) 848-6006.
Name of the person listed on the credit card *
First Last
Credit Card Number *
Expiration Date *
MM / YYYY
Security Code *
Amount To Charge Credit Card *
$ Dollars . Cents
By signing this form, Let Me Plan It,LLC has the right to debit your account for the amount indicated on or after the registration form has been submitted. Permission is given for one single transaction only, and does not provide authorization for any additional unrelated debits or credits to your account. A charge from Gogo Vacations, not Let Me Plan It, will appear on your credit card statement.
Cardholder Signature *
Clear
Please see the trip details listed below.
Breathless Riviera Cancun
Treat yourself to a well-deserved getaway to one of the most popular destinations in the world: Cancun, Mexico! Sink your feet on sugar white sands, bask in the ocean breeze and take a dip in turquoise blue waters. This is a trip that will refresh your body and mind. Spend four nights at the Breathless Riviera Cancun Resort & Spa – a vibrant, chic and modern all-suite resort for adults, like you, seeking a sophisticated and lively getaway.
Dates of Travel
Allure Junior Oceanview Double or Allure Junior Oceanview King - Single
Allure Junior Oceanview Double or Allure Junior Oceanview King - Double
Allure Junior Oceanview Double or Allure Junior Oceanview King - Triple
Room Choice *
Single
Double
Triple
Roommate(s)
Payment Due Dates
$100 per person deposit due 10/5/18
Payment due in full by 3/8/19

Payment Plan also available
Thank you for working with Let Me Plan It...Please contact Felicia Hepburn if you have any questions or concerns. Felicia@letmeplanit.net 224-848-6006

Registration Instructions

Passenger 1

Passenger 2

Credit Card Authorization

Please see the trip details listed below.

Breathless Riviera Cancun

Payment Due Dates